NEONATAL INFECTIONS

Neonatal infection is the one of the main cause of neonatal death. Neonates have
less immunity so they are more susceptible for infection.
Risk factors for neonatal infection

Rupture of membranes for more than 24 hours.

Mothers having streptococcal infection
Maternal intrapartum fever more than 100.4 degree ferenhit
Low birth weight baby
Repeated vaginal examination

Mode of infection
1. In antenatal period the infection can transmit through trans placental route
rubella, herpes, chicken pox, hepatitis B.
2. During intranatal period aspiration of amniotic liquor or meuconeum, early
membrane rupture, repeated vaginal examination may lead to neonatal
sepsis, pneumonia, meningitis.
While fetus is passing through the vagina eyes can be infected- ophthalmia
neonatrum, oral thrush with candida albicans.
3. During the postnatal period- nosocomial infection.
Prevention of neonatal infection:
1. Use of antiseptic and aseptic technique during labour
2. Avoidance of repeated vaginal examination
3. Prophylactic antibiotic drug should be given to the mother.
Treatment:
1.
2.
3.
4.
5.

Baby should be isolated

To control infection by adequate and appropriate antibiotics.
Provide adequate oxygenation
Maintain cleanliness of the baby
Provide proper eye care
BIRTH INJURIES

Birth injuries are those which occurs during labour and delivery. It can cause
neonatal death, morbidity or still birth.
Causes:
1.
2.
3.
4.
5.
6.

Prolonged labour
Cephalopelvic disproportion
Abnormal presentation
Instrumental delivery
Shoulder dystocia
Precipitate labour

Type of injuries:
1.
2.
3.
4.
5.
6.
7.
8.

Skin laceration, abrasion

Facial nerve injury, brachial plexus, spinal cord injury
Haemorrhage in eye
Rupture on internal organ- spleen, liver, adrenal gland
Dislocation of the hip, shoulder, cervical vertebrae
Cephalohematoma, skull fracture
Intracranial haemorrhage
Fracture of the femur, humerus, clavicle

Cephalohematoma:
Collection of blood between pericarnium and the flat bone of the skull. It is never
present on birth but it gradually develops after 12 to 24 hours of birth. The blood is
absorbed and no specific treatment is required but prevention of haemorhage and
infection is important.

INTRACRANIAL HAEMORRHAGE
Causes:

1. Excessive moulding in deflexed vertex

2. Rapid compression of the head
3. Instrumental delivery
Clinical Features:
1. Still birth may occur
2. Severe respiratory depression- apgar score 0-3
3. Cerebral irritation- high pitch cry, neck retraction, convulsion, vomiting,
bulging of the anterior fontanelle.
Prevention:
1.
2.
3.
4.

Continous fetal observation

Avoid traumatic vaginal delivery
Find out the difficult or abnormal labour and do appropriate management
Administration of vitamin K

Treatment
1. The baby should be nursed in quiet environment
2. Administration of oxygen
3. Maintain the temperature
4. Maintain the patent airway
5. Avoid hypoxemia
6. Restrict the handling of the baby
7. Maintenance of the fluid
8. Administer vitaminK
9. Administer prophylactic antibiotic to prevent infection
10. Administer anticonvulsant drug
11. Aspiration of the blood